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Reisinger A, Brücher VC, Krepler K, Liekfeld A. [The glass ceiling in ophthalmology]. DIE OPHTHALMOLOGIE 2025; 122:85-90. [PMID: 39653864 DOI: 10.1007/s00347-024-02152-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/19/2024] [Indexed: 02/04/2025]
Abstract
Currently, two thirds of medical students are female. However, women continue to be clearly underrepresented in leading medical positions, which is also true for ophthalmology. The scientific output of female ophthalmologists is increasing, more pronounced as first authors than last, but remains below that of male colleagues. However, a significant gender bias has been shown in the grant application processes. There are significantly more male surgeons in vitreoretinal, refractive, and corneal surgery. Concerning surgical training, it has been shown that female ophthalmologists operate less during their residency, especially in cataract surgery. Also among surgeons do women continue to shoulder the main responsibility for family and household, despite the negative consequences for their career. This publication presents an overview of the present career situation for women in ophthalmology and discusses possible measures to achieve gender equality, such as the establishment of mentoring programs and networks.
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Affiliation(s)
- Anna Reisinger
- Kepler Universitätsklinikum Linz, Johannes Kepler Universität, Krankenhausstraße 9, Linz, Österreich, 4040.
| | - Viktoria C Brücher
- Klinik für Augenheilkunde, Universitätsklinik Münster, Münster, Deutschland, Domagkstraße 15, 48149
| | - Katharina Krepler
- Klinik Landstraße und Klinik Donaustadt, Wiener Gesundheitsverbund, Wien, Österreich
- Karl Landsteiner Society, Institute for Retinal Research and Imaging, Wien, Österreich
| | - Anja Liekfeld
- Technische Hochschule Brandenburg, Brandenburg an der Havel, Deutschland
- Klinik für Augenheilkunde, Klinikum Ernst von Bergmann GmbH, Potsdam, Deutschland, Charlottenstraße 72, 14467
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Cote SL, Nguyen A, Berry JL, Reid M, Chang J, Chen J, Nguyen A, Chang MY. Gender Disparities in Mentorship and Career Outcomes in Ophthalmology. J Womens Health (Larchmt) 2024; 33:1120-1127. [PMID: 38634534 PMCID: PMC11807853 DOI: 10.1089/jwh.2023.0876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Background: Gender disparities in the field of ophthalmology have been increasingly recognized. Although mentorship has been proposed as a contributing factor, there are limited data on the differences in mentorship experiences by gender among ophthalmologists. Objective: The purpose of this study was to evaluate gender disparities in mentorship experiences among ophthalmologists, and the impact of mentorship disparities on career outcomes. Design: Prospective, cross-sectional study. Setting: Web-based survey distributed through ophthalmology listservs. Participants: Ophthalmologists and ophthalmologists-in-training who completed the survey. Exposure: Training and practicing in the field of ophthalmology. Main Outcome Measures: Mentorship score based on 10 items from a previously published scale of mentorship quality and self-reported career outcomes (income, job satisfaction, achievement of career goals, and support to achieve future career goals). Results: We received survey responses from 202 male and 245 female ophthalmologists. Female ophthalmologists reported significantly lower mentorship satisfaction and worse quality of mentorship (p < 0.03). Female ophthalmologists also reported significantly lower income, worse job satisfaction, and lower rates of goal achievement and support to achieve future goals; all of these career outcomes, except income level, were partly mediated by mentorship score (mediation effect ranged from 29% to 68%, p < 0.014). Conclusions and Relevance: Gender-based inequities in achievement of career goals and job satisfaction are partly mediated by disparities in mentorship. Therefore, focused mentorship of women in ophthalmology at all career stages is imperative to reduce these inequities.
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Affiliation(s)
- Stephanie L. Cote
- Division of Ophthalmology, The Vision Center at the Children’s Hospital Los Angeles, Los Angeles, California, USA
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Angeline Nguyen
- Division of Ophthalmology, The Vision Center at the Children’s Hospital Los Angeles, Los Angeles, California, USA
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Jesse L. Berry
- Division of Ophthalmology, The Vision Center at the Children’s Hospital Los Angeles, Los Angeles, California, USA
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Mark Reid
- Division of Ophthalmology, The Vision Center at the Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Jessica Chang
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Jenny Chen
- Kaiser Permanente, Oakland, California, USA
| | - Annie Nguyen
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Melinda Y. Chang
- Division of Ophthalmology, The Vision Center at the Children’s Hospital Los Angeles, Los Angeles, California, USA
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
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Rousta N, Hussein IM, Kohly RP. Sex Disparities in Ophthalmology From Training Through Practice: A Systematic Review. JAMA Ophthalmol 2024; 142:146-154. [PMID: 38236584 DOI: 10.1001/jamaophthalmol.2023.6118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Importance Sex-based research in medicine has revealed inequities against females on almost every metric at almost every career stage; ophthalmology is no exception. Objective To systematically review the experiences of females in ophthalmology (FiO) from training through practice in high-income countries (HICs). Evidence Review A systematic review of English-language studies, published between January 1990 and May 2022, relating to FiO in HICs was performed. PubMed, MEDLINE, and Embase electronic databases were searched, as well as the Journal of Academic Ophthalmology as it was not indexed in the searched databases. Studies were organized by theme at each career stage, starting in medical school when an interest in ophthalmology is expressed, and extending up to retirement. Findings A total of 91 studies, 87 cross-sectional and 4 cohort, were included. In medical school, mentorship and recruitment of female students into ophthalmology was influenced by sex bias, with fewer females identifying with ophthalmologist mentors and gender stereotypes perpetuated in reference letters written by both male and female referees. In residency, females had unequal learning opportunities, with lower surgical case volumes than male trainees and fewer females pursued fellowships in lucrative subspecialties. In practice, female ophthalmologists had lower incomes, less academic success, and poorer representation in leadership roles. Female ophthalmologists had a greater scholarly impact factor than their male counterparts, but this was only after approximately 30 years of publication experience. Pervasive throughout all stages of training and practice was the experience of greater sexual harassment among females from both patients and colleagues. Despite these disparities, some studies found that females reported equal overall career satisfaction rating with males in ophthalmology, whereas others suggested higher burnout rates. Conclusions and Relevance Ophthalmology is approaching sex parity, however, the increase in the proportion of females in ophthalmology had not translated to an increase in female representation in leadership positions. Sex disparities persisted across many domains including recruitment, training, practice patterns, academic productivity, and income. Interventions may improve sex equity in the field.
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Affiliation(s)
- Nikki Rousta
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Isra M Hussein
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Radha P Kohly
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
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Barequet IS, Rosenblatt A, Schaap Fogler M, Pedut-Kloizman T, Gaton D, Loewenstein A, Habot-Wilner Z. Gender related trends among Israeli ophthalmologists professional career and personal life performance. Eye (Lond) 2023; 37:3496-3501. [PMID: 37106146 PMCID: PMC10630451 DOI: 10.1038/s41433-023-02543-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/17/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Gender-diversity trends in ophthalmology in Israel have not been studied despite a high proportion of female ophthalmologists. Our purpose was to evaluate gender-related trends in ophthalmology professional career and personal life performance in early and advanced careers in Israel. METHODS A survey based on a nationwide voluntary anonymous web questionnaire was distributed to the members of the Israeli Ophthalmological Society. The questionnaire included questions referring to professional career and personal life performance. Gender differences were analyzed. RESULTS Out of 252 respondents, 116 (46%) were women, with a mean age of 47.97 + -11.3 and 53.18 + -12.4 (P = 0.01) years, respectively. Marital status, post-residency fellowship performance or duration, an additional academic degree, academic appointments, and managerial positions were similar between genders. Fellowship predominance of males was found in cornea/cataract/refractive and of females in strabismus, pediatric ophthalmology, and neuro-ophthalmology (P < 0.01, P = 0.032, respectively). Men had significantly more publications and appointments in peer review journals and work hours (P = 0.04 and P = 0.02, P = 0.027, respectively). Both genders responded similarly regarding work satisfaction, combination between family life and work. More women felt inequity during and post-residency in clinical (P = 0.011, P = 0.001, respectively) and surgical work (P = 0.001, P = 0.035, respectively). More women experienced inappropriate remarks from patients and sexual harassment (P = 0.001, P < 0.001, respectively), and supported the need for affirmative action (P < 0.0001). CONCLUSIONS Several gender disparities were found among ophthalmologists in Israel, including subspecialties distributions, publications, appointments in peer review journals, working hours, work inequity sense, harassment events, and support the need for affirmative action.
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Affiliation(s)
- Irina S Barequet
- Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Amir Rosenblatt
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Schaap Fogler
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | | | - Dan Gaton
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Anat Loewenstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Zohar Habot-Wilner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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An Eye on Gender Equality: A Review of the Evolving Role and Representation of Women in Ophthalmology. Am J Ophthalmol 2022; 236:232-240. [PMID: 34283980 DOI: 10.1016/j.ajo.2021.07.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE In recent decades, women have achieved greater representation in ophthalmology. Globally, women now constitute approximately 25%-30% of ophthalmologists and 35%-45% of trainees. Nevertheless, women remain under-represented in key areas, including positions of professional and academic leadership and ophthalmic surgical subspecialization. Furthermore, there is evidence that women in ophthalmology encounter more bias and discrimination across multiple domains than men, including a gender-pay gap that is wider than in many other surgical subspecialties. Women ophthalmologists and trainees report sharply differing training experiences from male peers, including fewer opportunities to operate, more bullying and harassment, less access to mentorship, and contrasting expectations around contributions to family life. DESIGN Perspective. METHODS An extensive literature search was undertaken to compile and review papers published with a focus on gender equity across ophthalmology, surgery, and medicine. RESULTS We identified 8 broad domains that were widely discussed: leadership, research and academics, income, surgical exposure and subspecialization, harassment, career satisfaction, mentorship, and family and marital differences. We have summarized the current research across each of these areas, and discussed possible solutions to reduce the inequities reported. CONCLUSIONS This review draws on current research published around representation and experiences of women in ophthalmology and suggests that there are opportunities to improve gender inequity.
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Rattan SA, Mutashar MK, AnNasseh MG, Al-Attar Z. Obstacles and Challenges Facing Iraqi Women Ophthalmologists. Middle East Afr J Ophthalmol 2022; 29:80-84. [PMID: 37123428 PMCID: PMC10138133 DOI: 10.4103/meajo.meajo_87_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 10/07/2022] [Accepted: 12/14/2022] [Indexed: 05/02/2023] Open
Abstract
PURPOSE The purpose of this study was to address disparities between male and female Iraqi ophthalmologists in terms of personal circumstances, professional profiles, and attitudes toward work and family life. METHODS A Google Form-based questionnaire was released on a social media platform including 500 ophthalmologists between September 1, and December 1, 2021. The survey included three domains: (1) demographic characteristics, (2) clinical practice profile, and (3) career satisfaction and work/family balance. RESULTS The study included a total of 209 specialists, with a response rate of 45.5%. About 69.4% of them were 45 years and younger. The female-to-male ratio was 1:1.6, 188 (90%) were married and 186 (88.9%) had children. Women ophthalmologists worked fewer hours, days, and operations than male ophthalmologists (P = 0.091). Moreover, women ophthalmologists in private practice were considerably underrepresented. General ophthalmologists represented 77%. The number of women ophthalmologists with subspecialty degrees was far less 9 (11.5%) than males 38 (29.2%), P = 0.003, and they performed significantly fewer operations than male ophthalmologists (P = 0.001). Family duties were the biggest deterrent for female ophthalmologists. For males, the private clinic is an obstacle to acquiring a specialty degree in 45.6%, but for women, it is just 25.7%. Overall satisfaction was 65.1%. Women respondents were less satisfied with their practice (P = 0.009) and thought that they are facing more challenges (0.007). Men believed they had less time to spend with family, implying that women sacrifice working time/income to satisfy family obligations and expectations. Work-life balance is achieved by limiting work hours and including family members. CONCLUSION Women ophthalmologists in Iraq might be facing greater obstacles to their professional advancement than their male counterparts. Female doctors were working fewer hours and doing fewer surgical procedures, and they were less likely to pursue subspecialty certification.
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Affiliation(s)
- Suzan A. Rattan
- Department of Surgery, Al-Kindy College of Medicine/University of Baghdad, Baghdad, Iraq
| | - Mahir K. Mutashar
- Kerato-Refractive Unit, Eye Specialist, Private Hospital, Baghdad, Iraq
| | | | - Zaid Al-Attar
- HLA Unit Al-Kindy College of Medicine/University of Baghdad, Baghdad, Iraq
- Address for correspondence: Dr. Zaid Al-Attar, Al-Kindy College of Medicine/University of Baghdad, Iraq. E-mail:
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Gedde SJ, Feuer WJ, Crane AM, Shi W. Factors Influencing Career Decisions and Satisfaction Among Newly Practicing Ophthalmologists. Am J Ophthalmol 2022; 234:285-326. [PMID: 34157277 DOI: 10.1016/j.ajo.2021.06.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/12/2021] [Accepted: 06/12/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To describe the career choices of newly practicing ophthalmologists and explore factors influencing career decisions and satisfaction. METHODS A cross-sectional study was conducted using data from an electronic survey of ophthalmologists who completed training within the prior 5 years. The survey included questions about demographic information, medical education, current practice, factors affecting career choices, and career satisfaction. Statistical comparisons were made based on gender, type of practice, subspecialty training, and practice area. RESULTS Surveys were completed by 696 (32%) newly practicing ophthalmologists, including 276 (40%) women, 179 (29%) academicians, and 465 (67%) subspecialists. A higher proportion of female respondents entered academics than male respondents (36% vs 26%, P = .009). Female and male respondents pursued fellowship training with similar frequency (64% vs 68%, P = .32), but men were more likely to seek vitreoretinal fellowships (30% vs 11%, P < .001) and women were more likely to undertake fellowships in pediatric ophthalmology (21% vs 8%, P < .001), uveitis (10% vs 2%, P = .002), and neuro-ophthalmology (6% vs 2%, P = .042). A total of 514 (83%) respondents reported being happy with work life. CONCLUSIONS The career choices of newly practicing ophthalmologists differ based on gender, type of practice, subspecialty training, and practice area. Many factors affect career decisions, and they have varying influence on subgroups within ophthalmology. Ophthalmologists have high levels of career satisfaction. This information may prove useful when developing workforce strategies to meet future eye care needs. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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Xepoleas MD, Munabi NCO, Auslander A, Magee WP, Yao CA. The experiences of female surgeons around the world: a scoping review. HUMAN RESOURCES FOR HEALTH 2020; 18:80. [PMID: 33115509 PMCID: PMC7594298 DOI: 10.1186/s12960-020-00526-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/15/2020] [Indexed: 05/25/2023]
Abstract
INTRODUCTION The Lancet Commission for Global Surgery identified an adequate surgical workforce as one indicator of surgical care accessibility. Many countries where women in surgery are underrepresented struggle to meet the recommended 20 surgeons per 100,000 population. We evaluated female surgeons' experiences globally to identify strategies to increase surgical capacity through women. METHODS Three database searches identified original studies examining female surgeon experiences. Countries were grouped using the World Bank income level and Global Gender Gap Index (GGGI). RESULTS Of 12,914 studies meeting search criteria, 139 studies were included and examined populations from 26 countries. Of the accepted studies, 132 (95%) included populations from high-income countries (HICs) and 125 (90%) exclusively examined populations from the upper 50% of GGGI ranked countries. Country income and GGGI ranking did not independently predict gender equity in surgery. Female surgeons in low GGGI HIC (Japan) were limited by familial support, while those in low income, but high GGGI countries (Rwanda) were constrained by cultural attitudes about female education. Across all populations, lack of mentorship was seen as a career barrier. HIC studies demonstrate that establishing a critical mass of women in surgery encourages female students to enter surgery. In HICs, trainee abilities are reported as equal between genders. Yet, HIC women experience discrimination from male co-workers, strain from pregnancy and childcare commitments, and may suffer more negative health consequences. Female surgeon abilities were seen as inferior in lower income countries, but more child rearing support led to fewer women delaying childbearing during training compared to North Americans and Europeans. CONCLUSION The relationship between country income and GGGI is complex and neither independently predict gender equity. Cultural norms between geographic regions influence the variability of female surgeons' experiences. More research is needed in lower income and low GGGI ranked countries to understand female surgeons' experiences and promote gender equity in increasing the number of surgical providers.
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Affiliation(s)
- Meredith D. Xepoleas
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
| | - Naikhoba C. O. Munabi
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
| | - Allyn Auslander
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
| | - William P. Magee
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles, Los Angeles, CA USA
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
- Division of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA USA
| | - Caroline A. Yao
- Operation Smile Inc, Virginia Beach, Virginia Beach, VA USA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, 1510 San Pablo St, Suite 415, Los Angeles, CA USA
- Division of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA USA
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Buys YM, Canizares M, Felfeli T, Jin Y. Influence of Age, Sex, and Generation on Physician Payments and Clinical Activity in Ontario, Canada: An Age-Period-Cohort Analysis. Am J Ophthalmol 2019; 205:184-196. [PMID: 31004590 DOI: 10.1016/j.ajo.2019.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/30/2019] [Accepted: 04/04/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare the effect of age, sex and generation on physician practice patterns in Ontario, Canada. DESIGN Retrospective cohort study. METHODS Physician and patient data from 1992-2013 were used to calculate the yearly number of physicians, distinct patients seen, patient visits, government payments, physician age, sex, specialty, and year of birth. Age-period-cohort models were used for analysis. RESULTS There was a negligible change in the number of distinct patients for all physicians and family physicians and a 20.6% decrease for ophthalmologists. There were small declines in yearly visits for all physicians (14.2%) and family physicians (17.3%) and a 10.0% increase for ophthalmologists. There were a lower number of visits (and patients for ophthalmologists) in each succeeding recent birth cohort. For all groups and birth cohorts, male physicians had a significantly greater number of visits and patients. Median payments increased over time in all groups and were less for women with an average women-to-men ratio of 0.64 for all physicians, 0.75 for family physicians, and 0.59 for ophthalmologists. After adjusting for the number of visits and patients, sex differences in payments remained significant for all physicians and ophthalmologists but were no longer significant for family physicians. CONCLUSION Younger cohorts of Ontario physicians have greater yearly payments compared with older cohorts at the same age despite similar or a slightly lower number of visits and patients. The sex gap of payments was mostly explained by differences in the number of patients and visits for family physicians but remained significant for all physicians and ophthalmologists.
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Lo TCS, Rogers SL, Hall AJ, Lim LL. Differences in practice of ophthalmology by gender in Australia. Clin Exp Ophthalmol 2019; 47:840-846. [DOI: 10.1111/ceo.13523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/01/2019] [Accepted: 04/21/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Tiffany C. S. Lo
- Ophthalmology, The Royal Victorian Eye and Ear Hospital Melbourne Victoria Australia
- The Centre for Eye Research Australia, The University of Melbourne Melbourne Victoria Australia
| | - Sophie L. Rogers
- The Centre for Eye Research Australia, The University of Melbourne Melbourne Victoria Australia
| | - Anthony J. Hall
- Department of OphthalmologyAlfred Health Melbourne Victoria Australia
| | - Lyndell L. Lim
- Ophthalmology, The Royal Victorian Eye and Ear Hospital Melbourne Victoria Australia
- The Centre for Eye Research Australia, The University of Melbourne Melbourne Victoria Australia
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Jain NS, Kersten HM, Watson SL, Danesh‐Meyer HV. Gender differences in Australasian ophthalmologists' experiences of the workplace. Clin Exp Ophthalmol 2019; 47:706-712. [DOI: 10.1111/ceo.13487] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/12/2019] [Accepted: 02/16/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Neeranjali S. Jain
- Prince of Wales Hospital Clinical SchoolUniversity of New South Wales Sydney New South Wales Australia
| | - Hannah M. Kersten
- School of Optometry and Vision ScienceThe University of Auckland Auckland New Zealand
| | - Stephanie L. Watson
- Prince of Wales Hospital Clinical SchoolUniversity of New South Wales Sydney New South Wales Australia
- Save Sight InstituteUniversity of Sydney Sydney New South Wales Australia
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Influence of Age, Sex, and Generation on Physician Payments and Clinical Activity in Ontario, Canada: An Age-Period-Cohort Analysis. Am J Ophthalmol 2019; 197:23-35. [PMID: 30236775 DOI: 10.1016/j.ajo.2018.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the effect of age, sex and generation on physician practice patterns in Ontario, Canada. DESIGN Retrospective cohort study. METHODS Physician and patient data from 1992 to 2013 were used to calculate yearly number of physicians, distinct patients seen, patient visits, government payments, physician age, sex, specialty, and year of birth. Age-period-cohort models were used for analysis. RESULTS There was a negligible change in the number of distinct patients for all physicians and family physicians and a 20.6% decrease for ophthalmologists. There were small declines in yearly visits for all physicians (14.2%) and family physicians (17.3%) and a 10.0% increase for ophthalmologists. There was a lower number of visits (and patients for ophthalmologists) in each succeeding recent birth cohort. For all groups and birth cohorts, male physicians had significantly greater number of visits and patients. Median payments increased over time in all groups and were less for women with an average women-to-men ratio of 0.64 for all physicians, 0.75 for family physicians, and 0.59 for ophthalmologists. After adjusting for the number of visits and patients, sex differences in payments remained significant for all physicians and ophthalmologists but were no longer significant for family physicians. CONCLUSION Younger cohorts of Ontario physicians have greater yearly payments compared to older cohorts at the same age despite similar or slightly fewer numbers of visits and patients. The sex gap of payments was mostly explained by differences in the number of patients and visits for family physicians, but remained significant for all physicians and ophthalmologists.
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Venkatesh R, Kumar S. Back pain in ophthalmology: National survey of Indian ophthalmologists. Indian J Ophthalmol 2017; 65:678-682. [PMID: 28820152 PMCID: PMC5598177 DOI: 10.4103/ijo.ijo_344_17] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The aim is to assess the prevalence, severity, and associations of back pain among Indian ophthalmologists. METHODS A self-reporting questionnaire was sent to ophthalmologists with valid e-mail addresses registered with the All India Ophthalmological Society. The survey was open for responses for 2 months. RESULTS A total of 651 (5.96%) responses were obtained; 394 (61%) males and 257 (39%) females. Half (50%) of responses were obtained from doctors belonging to 31-40 years' age group. Two hundred and thirty (35%) of the ophthalmologists had height ranging from 161 to 170 cm and 443 (68%) had weight ranging from 51 to 75 kg. Four hundred and eighty-one (73.8%) of the respondents had <15 years of ophthalmic experience. Cataract (346; 53.1%) and general ophthalmology (342; 52.5%) were commonly practised by the ophthalmologists. Time spent in the outpatient department (OPD) was 39.37 ± 16.32 h/week and in the operating theater 13.64 ± 9.89 h/week, respectively. Self-reported prevalence of back pain was 70.5%. Fully 49% of respondents had low back pain, followed by neck pain (33%) and upper extremity symptoms (16%). Age <50 years (odds ratio [OR] = 2.4485), female gender (OR = 2.0265), long working hours in OPD (OR = 1.6524), and performing retinal lasers and indirect ophthalmoscopy (OR = 3.3251) showed positive association with back pain. The intolerable back pain was noted in <7% of the respondents. Around 398 (61%) respondents felt that their back pain was exacerbated while doing work and 86.6% felt that up to 5 h/week was lost due to persistent backache. Yoga and some form of exercise (74.3%) was practised to alleviate back pain. CONCLUSION Back pain symptoms appear to be common among ophthalmologists. Awkward posture and prolonged working hours are responsible for developing back pain among ophthalmologists. Performing yoga and regular exercises, modifications in instrumentation and creating a larger workforce of eye care practitioners are needed to prevent ophthalmologists from developing back pain.
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Affiliation(s)
- Ramesh Venkatesh
- Department of Retina and Vitreous, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Sumit Kumar
- Department of Retina and Vitreous, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
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Saurabh K, Sarkar K, Roy R, Majumder PD. Personal and practice profile of male and female ophthalmologists in India. Indian J Ophthalmol 2016; 63:482-6. [PMID: 26265636 PMCID: PMC4550978 DOI: 10.4103/0301-4738.162579] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: The aim of this study was to study the practice pattern, personal profile, and work-family balance of male and female ophthalmologists in India. Materials and Methods: This study was conducted through 41 point questionnaire sent to the members of All India Ophthalmological Society dealing with practice profile and personal circumstances of ophthalmologists. Results: Six hundred and twenty-two (8%) responses were obtained out of 7723 invitations sent. A total of 452 were male and 170 were female ophthalmologists. Age group of 30–39 years was most common age of respondents (male 155; 35.3%; female 81; 47.6%). Larger number of male ophthalmologists (157; 34.7%) worked for more than 9 h a day than female ophthalmologists (41; 24.1%) (P = 0.01). Larger number of male ophthalmologists (229; 50.7%) earned more than Rs. 1 lakh/month than female ophthalmologists (55; 32.4%) (P = 0.00001) More female ophthalmologists (21; 12.4%) than males (26; 5.8%) said that they faced cultural, ethnic or gender bias at work place (P = 0.002). Forty-four (25.9%) female and 54 (12%) male ophthalmologists said that they often curtailed their work for family needs (P = 0.0001). Two hundred and fifty-two (55.8%) male ophthalmologists and 78 (45.9%) female ophthalmologists considered their profession rewarding (P = 0.02). Conclusion: Ophthalmology as a profession was considered rewarding by both male and female ophthalmologists. However, female ophthalmologists were curtailing their work for family needs and earning less than male ophthalmologists. Female ophthalmologists were also subject to gender bias at workplace. These issues need to be tackled to improve the work satisfaction of ophthalmology workforce.
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Affiliation(s)
- Kumar Saurabh
- Vitreoretina Services, Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India
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McAlister C, Jin YP, Braga-Mele R, DesMarchais BF, Buys YM. Comparison of lifestyle and practice patterns between male and female Canadian ophthalmologists. Can J Ophthalmol 2014; 49:287-90. [DOI: 10.1016/j.jcjo.2014.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 02/07/2014] [Accepted: 02/10/2014] [Indexed: 10/25/2022]
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Poppas A, Cummings J, Dorbala S, Douglas PS, Foster E, Limacher MC. Survey Results: A Decade of Change in Professional Life in Cardiology. J Am Coll Cardiol 2008; 52:2215-26. [PMID: 19095147 DOI: 10.1016/j.jacc.2008.09.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Career Satisfaction in Emergency Medicine: The ABEM Longitudinal Study of Emergency Physicians. Ann Emerg Med 2008; 51:714-722.e1. [DOI: 10.1016/j.annemergmed.2008.01.005] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2007] [Revised: 12/21/2007] [Accepted: 01/09/2008] [Indexed: 11/30/2022]
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Deva NC, Danesh-Meyer HV. Gender Differences in Income. Ophthalmology 2008; 115:411; author reply 411-2. [DOI: 10.1016/j.ophtha.2007.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Accepted: 10/04/2007] [Indexed: 11/25/2022] Open
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Danesh-Meyer HV, Deva NC, Ku JYF, Carroll SC, Tan YW, Gamble G. Differences in practice and personal profiles between male and female ophthalmologists. Clin Exp Ophthalmol 2007; 35:318-23. [PMID: 17539782 DOI: 10.1111/j.1442-9071.2007.01480.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess practice profiles and attitudes towards career and family among ophthalmologists in Australia and New Zealand, with an emphasis on identifying gender differences. METHODS A 43-part confidential survey addressing professional and personal issues was sent to all female ophthalmologists and to randomly selected age-matched male ophthalmologists, registered with the Royal Australian and New Zealand College of Ophthalmologists in 2005. RESULTS A total of 254 (75%) of the surveys were returned, with no significant difference in response rate between genders. Differences in practice profiles were identified: females preferentially practise in the city (89.6% vs. 76.1%, P<0.001), work fewer hours (70% of males working 40 hours per week, compared with 41% of females, P<0.0001) and work part time (57.5% vs. 13.6%, P<0.0001). Female ophthalmologists earn less (average income being NZ/Aus$37,913 [95% confidence interval 25,600-50,226] less, P<0.0001); the difference remained significant (P<0.0001) even when adjusted for hours worked. Up to 93.3% of male ophthalmologists are married or in a stable relationship, compared with 75.6% of females (P=0.0003), and males are more likely to have children (P=0.0007). There was no significant difference in overall career satisfaction between male and female ophthalmologists; however, females expressed greater frustration with managing professional and family commitments, and unequal career advancement opportunities. CONCLUSION Significant differences exist in practice profiles and personal circumstances between male and female ophthalmologists. Females appear to balance work and personal responsibilities by working fewer hours, and for lower income. Despite this, they are less likely to be in a stable relationship, or to have children. However, there is no difference between the two groups in overall career satisfaction.
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Baerlocher MO, Noble J. Does sex affect the success rate of Canadian ophthalmology residency applicants? Can J Ophthalmol 2006; 41:163-8. [PMID: 16767202 DOI: 10.1139/i06-003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite equalization of the ratio of men and women among matriculating medical students, it is possible that different rates of success for applicants at the level of resident selection in the annual residency match may occur on the basis of sex. As part of a larger project, we examined this issue across the medical specialties. In the current article, the effect of sex on resident selection within the specialty of ophthalmology is explored. METHODS Data were obtained from the Canadian Medical Association, Canadian Institute for Health Information, Royal College of Physicians and Surgeons of Canada, Canadian Ophthalmological Society, and Canadian Residency Matching Service regarding sex- and age-specific demographics, as well as success rates for male and female applicants ranking an ophthalmology residency program as their top choice. The proportion of men who ranked ophthalmology as their top choice but did not match to any ophthalmology program was compared to the corresponding proportion of women. RESULTS The female: male ratio of practicing ophthalmologists has slowly increased over the past decade and is highest (0.41:1) within the under-45 age group. By grouping data from 1993 to 2004, we found that men who ranked an ophthalmology program as their first choice had odds of not being accepted to an ophthalmology program that were 1.1 times (95% confidence interval 0.8-2.0; p=0.34) the corresponding odds for women. INTERPRETATION Our data suggest that discrimination on the basis of sex does not occur at the level of residency selection. The lower level of female recruitment may be due to decreased interest in this specialty among women. Nonetheless, the proportion of female ophthalmologists within the Canadian workforce continues to increase.
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Affiliation(s)
- Mark O Baerlocher
- University of Toronto Radiology Residency Training Program, Department of Ophthalmology and Vision Sciences, Ontario, Canada.
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Burke CA, Sastri SV, Jacobsen G, Arlow FL, Karlstadt RG, Raymond P. Gender disparity in the practice of gastroenterology: the first 5 years of a career. Am J Gastroenterol 2005; 100:259-64. [PMID: 15667479 DOI: 10.1111/j.1572-0241.2005.41005.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite an unprecedented demand for gastroenterology services, the number of gastroenterology trainees has decreased over 50% since 1993. Women comprise nearly 50% of the U.S. medical school student population; yet only occupy 16% of gastroenterology fellowship positions. In order to recruit the best candidates to gastroenterology we must be able to demonstrate the attractiveness of a career in the field. A prospective study was performed to identify the career choices of graduates from gastroenterology fellowship programs using a prospective study model and to identify whether gender differences exist in the practice of gastroenterologists up to 5 yr after completion of training. METHODS A survey gathering information on demographics, practice pattern, and income was mailed to two cohorts of gastroenterology fellows 3 and 5 yr after graduation. RESULTS A total of 247 subjects completed the 3 yr and 220 subjects responded to the 5-yr survey. At 3 yr, men reported higher income (p < 0.001), worked longer hours per week (p < 0.002), and were more likely to be part owner of the practice (p= 0.027). Females reported fewer children (p < 0.007), lower board certification rates (p < 0. 002), worked for larger, multispecialty practices (p < 0.001), and practiced more internal medicine. These differences were still present at 5 yr into gastroenterology practice. CONCLUSIONS Significant differences in practice type, earnings, board certification, professional standing, and alterations in family planning are noted between male and female gastroenterologists in the initial 5 yr of their practice.
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Affiliation(s)
- Carol A Burke
- The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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